Vidya Lakshmi Common Education Loan Application Form

Student ID 2008456

Application ID 1229277

Bank Name Punjab National Bank

Bank Scheme Name PNB PRATIBHA

Preferred Bank IFSC Code PUNB0083110

Preferred Bank Branch Name HOSUR

Date of Application 03-Nov-2021

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name BHARATHI SEKAR

Middle Name

Last Name S M

Father’s /Husband’s First Name SEKAR MADHAIYAR

Father’s /Husband’s Middle Name

Father’s /Husband’s Last Name M T

Date of Birth 19/06/1998 07/07/1974

Category OBC OBC

Sex Male Male

Marital Status Single Married

Educational Qualification B.E., Mechanical Engineering NA

Marks obtained in Highest

65.5 0.0 0.0
qualification %

Occupation Student Retired

Income from all sources (Rs) 10000.00 10000.00

PAN No.# DYUPB9536H CYZPS7823N

State Tamil Nadu Tamil Nadu

Address Line 1 613/1, Plot No 18, Krishna Nagar, 613/1, Plot No 18, Krishna Nagar,

Address Line 2 Dharga, Sipcot post, Hosur Dharga, Sipcot post, Hosur

Village / Area/ Locality Krishna Nagar Krishna Nagar

Block/Taluka /Sub-district/Town Krishnagiri Krishnagiri

PIN 635126 635126

Contact No. 8072999088 9994923567

e-mail Id bharathisekar360@gmail.com vetrivelsekar1994@gmail.com

Present Banker Details

Branch IFSC HDFC0000351

Banker HDFC BANK

Bank Branch HOSUR

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Account Type Savings Account

SB / OD A/c No. 50100421874466

Direct/Indirect liability details (Rs) 0

2. Whether related to Chairman /Directors / employee of our Bank or any other Banks. No

If yes, details of relationship

3. Particulars of course, for which loan is required.

Whether under: Merit / Management Quota Management Quota

Name of the Institution st.lewis college of management

Name of the Course MBA

Duration of the Course 02 (Years) 00 (Months)

Date of Commencement 02/08/2021 Date of Completion 30/06/2023

Cost of Finance Details

4. Cost of Course / Source of Finance: (All amounts are in (Rs))

Particulars Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

Tuition fees 150000 150000 300000.00

Exam fees 25000 25000 50000.00

Books Stationery 30000 30000 60000.00

Equipment/Computer 35000 35000 70000.00

Hostel Expenses 0 0

Sundries/Travel 40000 20000 60000.00

TOTAL 280000 260000 540000.00

Own Source / Scholarship 28000 0 28000.00

Loan Required 252000 260000 512000.00

5.Details of securities offered VETRIVEL SEKAR

6.Prospects of earning after completion of the course

No. of Installments Amount (Rs) p.m.

Repayment proposed
60 10000.00

7.Uploaded Documents:

Marksheet

Proof Of Admission to the course

Schedule Of Expenses for the course, as given by institution

Applicant Photo

Parent Photo

Co-obligant / Guarantor Photo

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I / We declare that all the particulars and information given in the application form are true, correct and complete and binding on me / us. Further,
the above particulars shall form the basis of any loan Bank may decide to sanction to me / us. The loan amount will be used for the purpose for
which it is granted.

Signature of the Signature of the Signature of the

Student Parent/Guardian Co-obligant/Guarantor

Place:

Date:

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For office use

Credit Report No. Date : Customer ID/Application ID:

Details of security including

Rate of Repayment Whether eligible under CSIS
Nature of limit Amount (Rs.) Margin(Rs.) Personal Guarantee/Co-
Interest* conditions Scheme / (Yes/No)
obligation.

Other terms and conditions:

The Bank may revoke in part or in full or withdraw/stop financial assistance at any stage by giving reasonable notice to the borrower. Credit
facilities sanctioned are to be availed within 6 months from the date of this letter, failing which; the limits will automatically stand cancelled.

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Manager/Senior Manager / Accepted all the terms and
Chief Manager /Asst Gen Manager conditions of sanction Borrower/s

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